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FDA Panel Votes to Eliminate Vicodin and Percocet



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No. 100
Old Jul 03, 2009, 03:45 PM

Default Re: FDA Panel Votes to Eliminate Vicodin and Percocet
Originally Posted by CapeCodMermaid View Post
Why don't we just eliminate stupid people who don't heed the warnings on the bottles of OTCs and be done with it?
Stupid people who don't need warnings?

Stupid people who do?

Stupid at all?

What are you actually saying?
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No. 101
Old Jul 03, 2009, 05:53 PM

Default Re: FDA Panel Votes to Eliminate Vicodin and Percocet
I'm saying that as always some of us will suffer because stupid people don't read the warnings on labels. If APAP 500mg is taken off the shelf, we can just take 3 or 4 of the regular strength.
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No. 102
Old Jul 03, 2009, 06:51 PM

Default Re: FDA Panel Votes to Eliminate Vicodin and Percocet
Originally Posted by maggiofliore View Post
as someone with chronic pain, I think the problem will be that these pure narcs are going to be schedule II, instead of schedule III if cut with acetaminophen. That means that I will have to see my MD in the office every time I want a refill. That sounds like nonsense to me.
This is a good point. I don't understand the rationale for scheduling these drugs differently since the scheduled medication is the opiate, not the Tylenol. 5 mg oxycodone = schedule II ; 5 mg oxycodone + 325 mg acetaminophen = schedule III
The only reason I can think of is that the 5/325 combo dosing must be limited d/t the risk of APAP toxicity. As a safety concern, this rationale doesn't really have a leg to stand on (obviously, or we wouldn't be having this discussion).

If combo medications are removed from the market, it would be nice if the FDA changed the scheduling accordingly.
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No. 103
from joyouter
Old Jul 03, 2009, 08:28 PM

Default Re: FDA Panel Votes to Eliminate Vicodin and Percocet
Pain management, acute or chronic remains one of the biggest challenges to all health care teams. As nurses, we are taught that pain is an individual symptom and its assessment is based upon accepting a patient's communication of pain and its severity´-an ethical approach which respects patient rights. Alongside, privately, many health care team members still experience scepticism of a suspected *seeker* vis a vis genuine pain and suffering. This can affect our overall judgement and objectivity during pain assessment and subsequent Rx.
Causes of pain, the *memory* of pain occurring within the spinal cord triggers the chronicity and escalation of pain, where the memory of chronic pain can dictate its treatment and can lead to our frustration at how elusive good pain management can be. Ideally, anticipation of pain, accepting what the patient's judgement and initiating good pain management early on can effectively resolve certain causes of pain eg. post op. I have seen many fresh post op major surgery patients arrive in RR without a good post op pain managment Rx, sometimes based upon the patients inter operative condition or subsequent to unforseen events during surgery. Despite this, pain management must be initiated, and titrated according to the patient's condition.
Tylenol which is believed to act in conjunction with calcium channel pathways in the spinal cord is usually prescrbed as an adjuvant and should be not used over an extended time. I think that it should not be included as a compound with other narcotics. The real danger lies in its ease of availability as an OTC and its extra strength Rx. The lack of public education about tylenol, deadly allergy and its secondary and accumulative effects on the liver is a gap in community/consumer education and, in reality, has not been addressed. The issues of Vicodin and Percocet are useful in pain management and should be prescribed by pain management specialists.
Building patient trust and collaboration in pain management takes time, empathy and skilled clinical assessment. Banning a particular narcotic which may provide effective pain relief has no relation to the reality of the side effects of the adjuvant and again illustrates the need for on going education and training for MD's /pain management nursing specialists.
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No. 104
from psalm
Old Jul 03, 2009, 11:46 PM

Default Re: FDA Panel Votes to Eliminate Vicodin and Percocet
Originally Posted by CapeCodMermaid View Post
Why don't we just eliminate stupid people who don't heed the warnings on the bottles of OTCs and be done with it?
...thanks for the laugh! But I agree. It is so frustrating to learn the patient takes Nyquil and tylenol and aspirin at home all at once, because "they are all over the counter so they must be safe".
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No. 105
from 300g
Old Jul 04, 2009, 05:25 AM

Default Re: FDA Panel Votes to Eliminate Vicodin and Percocet
Originally Posted by azhiker96 View Post
Maybe we need a campaign to tell that public that all drugs, even OTC can be dangerous/deadly if misused.
Tylenol recently aired a campaign on TV about the dangers of taking too much. "Take the recommended dose or don't take it at all... more is not better"... something along those lines.
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No. 106
Old Jul 04, 2009, 02:59 PM

Default Re: FDA Panel Votes to Eliminate Vicodin and Percocet
Originally Posted by hypocaffeinemia View Post
If you read the article you'll see that the hydrocodone in vicodin isn't the problem-- it's the acetaminophen.

There's no special reason hydrocodone et al has to be packaged and taken with acetaminophen or ibuprofen, to the best of my knowledge. The problem is that acetaminophen is so prolific in combination medications that many laypeople don't realize they're even taking it or how much they've taken.
Exactly. Acetaminophen was added to these meds so that companies could get a patent on them. The main pain-killers in them are so old they are no longer protected by patent laws. Patients will still be able to get hydrocodone and oxycodone for pain. Also, for some reason, Vicodin and its generic equivalents are classified as CIII drugs, not CII, so in most states, patients can get refills for up to 6 months from the date of the original Rx.

When we took my husband to a pain management specialist this year (hubby has chronic intractable pelvic pain), the first thing the doctor did was take him off all the meds that have NSAIDs in them and put him on non-combination opioids. He said it is way to easy to blow out your liver on those drugs, especially if you take extra-strength Tylenol or Tylenol PM as part of your OTC drug regimen.
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No. 107
from sansus3002
Old Jul 05, 2009, 03:11 AM

Default Re: FDA Panel Votes to Eliminate Vicodin and Percocet
I suffer from chronic pain from fibromyalgia and have for over 20 years now. I did not take any meds for a very long time, but now rely on pain medication (hydrocodone and tramadol) to give me some quality of life besides being in bed every day all day long. I am only 38 years old and I have 2 children still at home. I have been through the wringer with doctors not wanting to give me anything because the pain was all in "my head" and feeling like I was labeled a "druggie" or worse because I was in so much pain that I could not even think straight (literally!!). If the FDA removes these drugs without some sort of replacement, those of us who are using them because we have a real reason will be left to suffer and curl up and die with our pain. No one can understand what it is like until they have been there. People can throw out alot of accusations and "words" but you just cannot truly understand until you deal with it everyday.
I truly hope that the FDA will reconsider and think of those who will be inhumanely treated if they do do away with these drugs. Pain management is necessary and real and there are truly those of us who need someone to understand and try to at least comprehend some of the pain that we face everyday!
The acetaminophen in the medication is not the problem, if you ask me anyway. It is the fact that some people just do not know what is in the drugs and need to be educated. If they do not control the OTC products, the problem still remains, whether or not they take the narcotic drugs away or not. People who cannot get the narcotics will take extreme amounts of acetaminophen, etc. to try to control their pain instead and then where will they be??
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No. 108
Old Jul 05, 2009, 09:03 AM

Default Re: FDA Panel Votes to Eliminate Vicodin and Percocet
Originally Posted by sansus3002 View Post
I suffer from chronic pain from fibromyalgia and have for over 20 years now. I did not take any meds for a very long time, but now rely on pain medication (hydrocodone and tramadol) to give me some quality of life besides being in bed every day all day long. I am only 38 years old and I have 2 children still at home. I have been through the wringer with doctors not wanting to give me anything because the pain was all in "my head" and feeling like I was labeled a "druggie" or worse because I was in so much pain that I could not even think straight (literally!!). If the FDA removes these drugs without some sort of replacement, those of us who are using them because we have a real reason will be left to suffer and curl up and die with our pain. No one can understand what it is like until they have been there. People can throw out alot of accusations and "words" but you just cannot truly understand until you deal with it everyday.
I truly hope that the FDA will reconsider and think of those who will be inhumanely treated if they do do away with these drugs. Pain management is necessary and real and there are truly those of us who need someone to understand and try to at least comprehend some of the pain that we face everyday!
The acetaminophen in the medication is not the problem, if you ask me anyway. It is the fact that some people just do not know what is in the drugs and need to be educated. If they do not control the OTC products, the problem still remains, whether or not they take the narcotic drugs away or not. People who cannot get the narcotics will take extreme amounts of acetaminophen, etc. to try to control their pain instead and then where will they be??
First of all, I am very sorry for your suffering. Fibromyalgia is a complex diagnosis, and while it's hard to make, the signs and symptoms are similar across the board for those who carry this debilitating syndrome. I believe that it will be a focus in the future of pain medicine and that it may actually teach us more about how the body receives and interprets painful stimuli. As for the treatment that you are on--hydrocodone & tramadol--I don't think this will be affected if the FDA decides to implement this ban. Your provider can prescribe a form of hydrocodone that doesn't contain acetaminophen, and tramadol is not a combo drug at all. I know it's kind of a long thread, but I recommend looking through some of the responses in here--they may give you a better understanding about what the implications of this potential ban are. I think the most important thing to point out though--because you're not the only person to have mentioned this--is that narcotic analgesics are not going away, and provider's aren't going to stop prescribing appropriate pain medication for their patients. The big change is that if you feel Tylenol is an integral part of you pain management regimen, you will have to take it separately, rather than in combination tablets like percocet and vicodin.

No one who suffers from pain--acute or chronic--should be negatively affected by this ban, should it take place.
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No. 109
from 300g
Old Jul 05, 2009, 10:32 AM

Default Re: FDA Panel Votes to Eliminate Vicodin and Percocet
Yesterday I broke my foot... *grumble grumble*... I have never taken Percocet before, but THANK G*d (or the ER doc) for prescribing it for me. And, THANKFULLY it is available for prescription.

SIMPLY STATED AGAIN... eliminating Vicodin and Percocet WILL NOT solve Tylenol related problems. Why is that so hard to understand? Maybe the FDA Panel has not reached Piaget's Formal Operations stage...
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